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Intraspinal extradural gout tophus in the lumbar vertebral canal: Case reports Research Article

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Published article

RATIONALE: Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal.
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Medicine (Baltimore). 2022 Jan 7;101(1):e28418. doi: 10.1097/MD.0000000000028418.

ABSTRACT

RATIONALE: Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal.

PATIENT CONCERNS: The 2 patients presented with typical radiculopathy symptoms and a positive straight leg raise. In 1 case, there was weakness of the left toe extensors, with a positive left femoral nerve traction test. Additionally, the left patellar tendon reflex was weak. In the other patient who was unable to walk, there was a sensory deficit in the saddle distribution.

DIAGNOSIS: Histopathological examination of the specimens taken from the operation confirmed the presence of gouty deposits.

INTERVENTIONS: Posterior decompression was performed in these 2 cases, and chalky-white materials were identified in the lumbar vertebral canal.

OUTCOMES: No evidence of neoplasm, infection, or synovial cyst was found.

LESSONS: Definitive diagnosis of intraspinal extradural gout tophus, mimicking a sequestrated intervertebral disc or an extradural tumor, may be difficult. The initial suspicion of intraspinal gouty deposits, based on the diagnostic/management algorithm, may effectively avoid incorrect diagnosis via a less invasive procedure than explorative laminectomy.

PMID:35029886 | DOI:10.1097/MD.0000000000028418

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Intraspinal extradural gout tophus in the lumbar vertebral canal: Case reports

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Medicine (Baltimore). 2022 Jan 7;101(1):e28418. doi: 10.1097/MD.0000000000028418.ABSTRACTRATIONALE: Intraspinal gout tophus in the lumbar vertebral canal associated with gouty arthritis is rare. We present 2 cases with the first manifestations of a sequestrated intervertebral disc and an extradural tumor, and histopathologically proven to be gouty deposits in the lumbar vertebral canal.PATIENT CONCERNS: The 2 patients presented…

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